Individual provider Active NPI

Ilya Krayevsky, MD

  • Anesthesiology Physician
  • Long Beach, NY
National Provider Identifier
1407021231
Registry record updated Jul 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
264881 Issued in NY
Practice address
710 E Walnut St
Long Beach, NY 11561-3834
Phone
(516) 521-8003
NPI assigned
Apr 23, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 264881 NY Primary

Addresses

Primary practice location

710 E Walnut St
Long Beach, NY 11561-3834

Mailing address

3 Boyle Rd
Selden, NY 11784-4000
Phone (631) 736-4064

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130413000076 NY Practitioner - Anesthesiology 7214173442 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Long Island Anesthesiologists, PLLCGroup PAC ID 5799677902, 44 clinicians

Practice addresses (Care Compare)

1000 Montauk Hwy
West Islip, NY 11795-4927
Phone (631) 376-4444

Hospital & facility affiliations

  • Good Samaritan Hospital Medical Center Hospital, West Islip, NY, CCN 330286

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
264881NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Hospital Medical Center Current Accepting new patients
Long Island Anesthesiologists, PLLC Anesthesiology CurrentSince Jan 16, 2013 Accepting new patients
Good Samaritan Hospital Medical CurrentSince Mar 1, 2020 Accepting new patients

Locations

369 E Main St
Ste 18
East Islip, NY 11730
Phone (631) 277-1600

3 Boyle Rd
Selden, NY 11784
Phone (631) 716-6000

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

160 Crossways Park Dr
Woodbury, NY 11797
Phone (516) 364-4200

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405036800000",
    "number": "1407021231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 BOYLE RD",
            "city": "SELDEN",
            "state": "NY",
            "postal_code": "117844000",
            "telephone_number": "631-736-4064",
            "fax_number": "631-736-1332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 E WALNUT ST",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115613834",
            "telephone_number": "516-521-8003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAYEVSKY",
        "first_name": "ILYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-23",
        "last_updated": "2014-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "264881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, NY

Sources for this page

Verify at the official NPI Registry.